NGO Engagement in U.S. Global Health Efforts: U.S.-Based NGOs Receiving USG Support Through USAID

Non-governmental organizations (NGOs) are key partners in U.S. global health efforts. Indeed, a significant share of U.S. government funding for global health is channeled to NGOs, who act as program implementers on the ground. To date, however, little information has been available about the extent of their role in carrying out U.S. global health programs.  To help fill this void, this report provides an analysis of U.S.-based NGOs that received global health funding from the U.S. government (USG) during FY 2013. It specifically focuses on funding provided to NGOs by the U.S. Agency for International Development (USAID), the largest implementer of global health activities among USG agencies and departments. The focus on USAID is due both to the availability of data from this agency and the fact that USAID spending represents the majority of bilateral U.S. global health spending.¹ Key findings include (also see Table 1 below):

• Total Number of NGOs: In FY 2013, 135 U.S.-based NGOs received USG global health funding through USAID to implement global health activities. They include NGOs working on specific global health issues, those working in multiple health areas, as well as those with an even broader development scope. About 15% (20 NGOs) are faith-based organizations.
• Total Funding: Collectively, these NGOs received more than a third (approximately $2.32 billion) of USAID global health disbursements in FY 2013. The vast majority of this funding (91%) was concentrated among 20 NGOs. Funding amounts ranged from a high of more than $50 million per NGO (11 NGOs) to less than $1 million (74 NGOs).
• Program Areas: NGOs carry out global health efforts in all major U.S. program areas, with HIV receiving the highest amount of funding and involving the greatest number of NGOs. Family planning/reproductive health receives the second highest amount of funding, followed by maternal, newborn, and child health.
• Geographic Presence: NGOs received USG global health funding for efforts carried out in 72 countries and across multiple regions, including Africa, Asia, Europe & Eurasia, Latin America & the Caribbean, and the Middle East. Many NGOs (78) implement efforts that are “worldwide” in scope, though most (105) are engaged in regional and/or country-specific programs. Two-thirds of funding to NGOs ($1.57 billion) supports regional and country-specific efforts, while the remainder ($0.74 billion) is directed to “worldwide” efforts. Among the 103 engaged in country-specific efforts, the majority of NGOs (61) received funding for efforts in one country, while the remainder (42) received funding for efforts in two or more countries, including 19 that received funding in 10 or more countries. Nearly all countries (64 of 72) host activities by more than one NGO, with more than a quarter (20) – mostly in sub-Saharan Africa – hosting activities by 10 or more NGOs each. Overall, more NGOs operate in Africa than in all other regions combined.

Table 1: Summary of U.S.-Based NGO Engagement in USG Global Health Efforts, FY 2013
# of NGOs
135 of which, 20 are faith-based organizations
USG Global Health Funding Provided by USAID
$2,316,727,617 to U.S.-based NGOs
# of NGOs by Program Area
HIV	75
Maternal, Newborn, and Child Health (MNCH)	62
Family Planning/Reproductive Health (FP/RH)	43
Water Supply and Sanitation	40
Malaria	34
Nutrition	34
Tuberculosis (TB)	22
Other Public Health Threats, including NTDs+2	13
Pandemic Influenza and Other Emerging Threats (PIOET)3	7
Countries Reached
72*
NOTES: Reflects U.S.-based NGOs that received funding disbursed by USAID in FY 2013 for USG global health activities. + NTDs are neglected tropical diseases. * Other countries may have been reached through regional programs or “worldwide” efforts. SOURCES: KFF analysis of USAID FY2013 transaction data, downloaded 10-10-2014 through the U.S. Foreign Assistance Dashboard (ForeignAssistance.gov) as well as information from NGO websites.